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Cited by 38Thyroid Cancer Diagnosis and TreatmentThyroid Disorders and TreatmentsThyroid and Parathyroid Surgery

L‐T3 preparation for whole‐body scintigraphy: a randomized‐controlled trial

Leboeuf, Rébecca, Perron, Patrice, Carpentier, André C., Verreault, Jean, Langlois, Marie‐France·2007·Clinical Endocrinology
DOI 10.1111/j.1365-2265.2007.02972.x
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Abstract

Summary: Background Patients with thyroid cancer often need whole‐body scintigraphy (WBS) under TSH stimulation after 4–6 weeks withdrawal from levothyroxine (L‐T 4). Patients often become severely hypothyroid with impaired quality of life. Liothyronine (L‐T 3) substitution is used empirically to prepare patients; however, no data exist to prove its benefit. Objectives To compare the hypothyroid state in patients receiving either placebo or L‐T 3 following L‐T 4 withdrawal and to evaluate the time needed for adequate TSH elevation in preparation for WBS. Methods At the time of L‐T 4 withdrawal, patients were randomized to receive L‐T 3 (50 µg qd) or placebo for 3 weeks, after which treatment was stopped. A validated evaluation of hypothyroidism (Billewicz score) was administered in a double‐blind fashion every 2 weeks until the WBS. TSH, fT 4 and fT 3 were measured weekly. Results A total of 20 patients were randomized between September 2003 and May 2005. There was no difference in the Billewicz score at any time between the two groups. Before WBS, both groups were profoundly hypothyroid. TSH at time of WBS was similar in both groups. The time needed to reach a TSH level of more than 30 mUI/l was longer in L‐T 3 group (mean ± SD: 32 ± 4 days vs. 17 ± 9 days in placebo group, P = 0·006). Conclusion Preparation for WBS with L‐T 3 does not prevent profound hypothyroidism and delays TSH elevation required for WBS. L‐T 4 withdrawal alone for 2–3 weeks is simpler and sufficient to allow TSH to reach a level of more than 30 mUI/l in the majority of patients without increasing morbidity from hypothyroidism.

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Crossref · 10.1111/j.1365-2265.2007.02972.x

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  • Withdrawal of LT4 or LT3 leads to recurrence of hypothyroidism in patients who had thyroid surgery for thyroid cancer or were diagnosed with profound hypothyroidism.

    “Although there are no randomized clinical trials comparing LT4 to placebo to treat hypothyroidism, it has clearly been demonstrated that LT4 or LT3 withdrawal leads to a recurrence of hypothyroidism in patients who have undergone thyroid surgery for thyroid cancer or who were diagnosed with profound hypothyroidism (44-46).”

    From Guidelines for the Treatment of Hypothyroidism: Prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement (2014) · cites this paper as [44]

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Authors
Leboeuf, R., Perron, P., Carpentier, A. C., Verreault, J., & Langlois, M.
Affiliations
Université de Sherbrooke (CA)
Corresponding author
Langlois, Marie‐France
ORCID
Venue
Clinical Endocrinology
Publisher
Wiley
Published
2007-08-29
Volume
67
Issue
6
Pages
839-844
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/j.1365-2265.2007.02972.x
OpenAlex
W2145982910
Cited by
38
References
30
Citations by year
2026: 1 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 1 · 2019: 4 · 2018: 1 · 2017: 2 · 2016: 4 · 2015: 1 · 2014: 3 · 2013: 1 · 2012: 2
FWCI
2.44
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
liothyronine, levothyroxine withdrawal, whole-body scintigraphy, thyroid cancer, TSH stimulation, hypothyroidism, TSH elevation
MeSH terms
Adult, Double-Blind Method, Female, Humans, Hyperthyroidism, Hypothyroidism, Male, Middle Aged, Radionuclide Imaging, Thyroid Neoplasms, Thyrotropin, Thyroxine, Triiodothyronine, Treatment Outcome

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